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Home Health Therapies - Important Questions

care agency patient manager

Someone who is a candidate for home care should have the following questions answered— by a doctor, a hospital, a home care agency, or a state or local health agency—before starting care.

1. What kind of agency is providing the care?

  • • Find out the full name of the agency and what type of agency it is (e.g., a CHHA or hospice).
  • • Ask if the agency is accredited (e.g., through the Joint Commission on Accreditation of Health Organizations (JCAHO) or Community Health Accreditation Program (CHAP)).
  • • Call the state licensing agency (usually the state Department of Health) to find out if there are any outstanding complaints against the agency.

2. Who will provide the care?

  • • Ask for the credentials and experience of the person(s) who will provide the care.
  • • If the patient has a rare or difficult-to-treat problem, find out if the health care provider has received specialized training.

3. Who is in charge?

  • • Find out who is responsible for coordinating care and how to contact them.
  • • Ask who the home health aide reports to.
  • • Find out what kind of backup system exists if the home care provider does not show up.
  • • Ask for phone numbers to call to (1) contact the case manager, (2) report a no-show or other urgent problem, (3) report a nonurgent problem, and (4) make a complaint.

4. What services will the patient receive?

  • • Ask the case manager for the care plan after the first assessment visit is made. The plan of care should include the condition the patient is being treated for, the expected outcome when service ends, the type of therapies that will be received and from whom, the frequency of visits, and when the home care is expected to end.
  • • Be sure to ask the case manager or the doctor any questions about the plan of care.
  • • Ask the case manager to update the patient, the doctor, and the insurance company if the plan of care changes or is expected to change.

5. How much will the patient pay?

  • • Ask the insurance company if precertification or any other requirements must be met before beginning care.
  • • Ask the insurance company what the patient will be obligated to pay, based on the plan of care. Call the insurance company directly; benefit booklets, Web sites, and other sources may be out-of-date or may not be specific enough.
  • • Ask the agency about the option of paying out of pocket for extra care or for care after the insurance coverage runs out.
  • • Ask the agency if the patient is eligible to receive any charitable care dollars or is eligible for Medicaid or any special government programs or long-term care plans.

6. Is home care the best choice?

  • • Ask the case manager or doctor what can be done to get the most out of the home care experience.
  • • Ask the case manager or doctor what the alternatives to home care are.
  • • Find out what should be done when home care ends.
Home Health Therapies - The Future Of Home Care [next] [back] Home Health Therapies - Paying For Care

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